Metronidazole - Use In Gynecology: Properties And Instructions

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Metronidazole - Use In Gynecology: Properties And Instructions
Metronidazole - Use In Gynecology: Properties And Instructions

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Video: Metronidazole - How it acts? | Mechanism, side effects and uses 2023, February
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Metronidazole - the use of drugs in gynecology. Trichomoniasis, amebiasis, infections of bones and joints, central nervous system, condition after gynecological operations - this is the smallest list of indications for the use of the drug "Metronidazole". There are several different forms of release of the drug, the optimal form and dosage are best discussed with your doctor.

The content of the article:

  • 1 What is the medicine metronidazole
  • 2 Composition and form of release of the drug metronidazole
  • 3 Pharmacological action of the drug metronidazole
  • 4 Pharmacokinetics of the drug metronidazole
  • 5 Use of metronidazole tablets
  • 6 How to be treated with metronidazole
  • 7 Metronidazole in the fight against bacterial vaginosis
  • 8 Metronidazole - use in gynecology
  • 9 Features of use during pregnancy and lactation
  • 10 Recommendations for the use of metronidazole

What is the medicine metronidazole

The drug metronidazole belongs to the type of active antimicrobial drugs with a spatial radius of action for the constant therapy of infectious diseases provoked by parasites and anaerobes.

Instructions for the use of metronidazole tablets in gynecology
Instructions for the use of metronidazole tablets in gynecology

The action of the drug in tablets is based on a decrease in the oxidation state of the 5-nitro group by proteins of anaerobes and parasites. The altered 5-nitro group acts with the deoxyribonucleic acid of organisms, suppressing the union of enzymes, which leads to the destruction of unicellular organisms. It successfully fights against vaginal infections, amebiasis, bacterial vaginosis, intestinal giardiasis, parasites, and anaerobes.

When interacting with the antibiotic amoxil, metronidazole is more active against the bacteria that causes gastric and duodenal ulcers.

Metronidazole - the use of which has an effect on parasites and various types of microorganisms and has antibacterial and antiparasitic activity.

Due to the fact that aerobes are not susceptible to the direct action of metronidazole, but if a combination of anaerobic microorganisms with aerobic microorganisms is detected, the effect of metronidazole with antibiotics is successful. Metronidazole facilitates radiation therapy, activates the self-healing activity of cells.

Instructions for the use of metronidazole tablets in gynecology
Instructions for the use of metronidazole tablets in gynecology

Metronidazole is used to treat bacterial vaginosis. The cause of this pathology is a violation of the vaginal ecosystem and activation of the growth and reproduction of both obligate anaerobes and Gardnerella spp. This microaerophile is well associated with obligate anaerobes.

Inhibition of the growth of Gardnerella spp. is largely a consequence of the normalization of the vaginal biocenosis as a result of suppression of the reproduction of anaerobes. Nevertheless, the direct direct effect of metronidazole on gardnerella cannot be ruled out, especially in the case of strains with a sufficiently high sensitivity to 5-NIMZ. There is a positive experience of using other 5-NIMZ in the treatment of bacterial vaginosis.

Composition and form of release of the drug metronidazole

Instructions for the use of metronidazole tablets in gynecology
Instructions for the use of metronidazole tablets in gynecology

Metronidazole - application externally in the form of a cream, vaginal gel, vaginal suppositories, vaginal tablets, powder for preparation of solution for intravenous administration, solution for infusion, suspension for oral administration, tablets, coated tablets.

Active active ingredient:

Metronidazole is available in the form of yellowish-green flat-cylindrical, chamfered and scored tablets. One tablet contains 0.25 g of metronidazole.

Metronidazole is produced in the form of a cream for external use, in 1 g of which the content of metronidazole is 0.01 g.

Metronidazole is produced in the form of elongated white-yellow intravaginal suppositories. 1 candle contains metronidazole 0.125 g, or 0.25 g, or 0.5 g.

Metronidazole is available as a 0.5% greenish solution for injection. 1 ml of solution contains 5 mg of metronidazole.

Additional substances: in tablets - potato starch, cetylacetic acid, steatite. The cream contains propanetriol, liquid paraffin, emulsion wax, propanediol, nipagin, para-hydroxybenzoic acid, propyl ester, sodium salt, sterile water. In candles - polyethylene glycol 400, polyethylene glycol 1500. In solution - sodium dihydrogen phosphate, citric acid, sodium chloride, purified water.

Instructions for the use of metronidazole tablets in gynecology
Instructions for the use of metronidazole tablets in gynecology

Packaging of the medicine Metronidazole: one blister contains 10 tablets. 1 tablet contains 0.25 g of metronidazole. 1% cream is in a 25 g tube. 1 g of cream contains 10 mg of metronidazole.

1 cell package contains 7 vaginal suppositories. 1 candle contains 500 mg of metronidazole.

1 bottle for infusion contains 10 ml of solution. 1 ml of solution contains 5 mg of metronidazole.

1 ampoule of 0.5% injection solution contains 20 ml of the drug. 1 ml of solution contains 5 mg of metronidazole.

Pharmacological action of the drug metronidazole

Antiprotozoal and antimicrobial drug derived from 5-nitroimidazole. Metronidazole - the application and mechanism of action consists in the biochemical reduction of the 5-nitro group by intracellular transport proteins of anaerobic microorganisms and protozoa.

The reduced 5-nitro group interacts with the DNA of the cell of microorganisms, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria.

Active against Trichomonas vaginalis, Entamoeba histolytica, Gardnerella vaginalis. Giardia intestinalis, Lamblia spp., As well as obligate anaerobes Bacteroidcs spp. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacleroides vulgatus), Fusobacterium spp., Veillonela spp., Prevotella (P.bivia, P.buccae, microorganisms and P..dismpos) Eubacterium spp., Clostridium spp., Peptococcus spp., Peptostreptococcus spp.).

Aerobic microorganisms and facultative anaerobes are not sensitive to metronidazole, but in the presence of mixed flora (aerobes and anaerobes), metronidazole acts synergistically with antibiotics effective against conventional aerobes.

The minimum inhibitory concentration for these strains is 0.125-6.25 μg / ml. In combination with amoxicillin, it is active against Helicobacter pylori (amoxicillin inhibits the development of resistance to metronidazole).

Increases the sensitivity of tumors to radiation, causes sensitization to alcohol (disulfiram-like action), stimulates reparative processes.

Pharmacokinetics of the drug metronidazole

Metronidazole - application in tablets reaches 80% due to good penetration. Reaches sufficient concentrations in the cells of the body. It is found in the tissues of the lungs, kidneys, liver, skin, bile, brain, vaginal secretions, seminal fluid, breast milk. The drug crosses the intercellular and placental barriers.

From 30% to 60% of the drug enters the body into metabolism. The main intermediate product of metabolism acts directed towards parasites and microbes.

The drug is excreted up to 80% by the kidneys and up to 15% by the gastrointestinal tract. For patients with kidney disease, it is recommended to reduce the standard dose. With hemodialysis, metronidazole can be easily removed from the blood.

With vaginal use of metronidazole, the drug is partially absorbed, in a minimum amount (about 1.4%). The share of the absorbed drug in the case of intravaginal use reaches 20% when compared with taking pills. Approximately 20% of the dose is excreted by the excretory organs.

Instructions for the use of metronidazole tablets in gynecology
Instructions for the use of metronidazole tablets in gynecology

In the case of intravenous infusion, the drug, overcoming the placenta, is found in the lungs, bile, liver, kidneys, brain, bone tissue, cerebrospinal fluid, urethral and vaginal secretions, breast milk. Synthesis with proteins reaches 20%. It is processed in the liver.

Excretion from the body occurs through the kidneys. The half-life of metronidazole is seven hours. In case of impaired liver and kidney activity, a slower half-life of the drug is possible. In the case of the secondary use of metronidazole, its concentration in the body increases.

The use of metronidazole tablets

Metronidazole tablets should be used exclusively for the treatment of infectious processes excited by metronidazole cultures of viruses (according to the results of biological analysis or according to epidemiological indicators):

  • trichomoniasis; amoebiasis; anaerobic bacterial infections; infections of the skin and appendages; gynecological infections (including endometritis, endomyometritis, tubo-ovarian process, infections after gynecological operations);
  • bacterial septicemia; infections of bones and joints;
  • central nervous system infections, including meningitis, brain abscess, lower respiratory tract infections, pneumonia, empyema, lung abscess, endocarditis.

How to be treated with metronidazole

Metronidazole - use for adults and children over twelve years of age is administered intravenously in an amount of 100 ml for 30 minutes (5 ml / min) every eight hours. Patients suffering from kidney disease, the intervals between injections should be twelve hours. For patients with severe liver disease, it is necessary to monitor the amount of metronidazole in the blood.

Instructions for the use of metronidazole tablets in gynecology
Instructions for the use of metronidazole tablets in gynecology

If the concentration of the drug is high, the recommended daily dose is reduced. For the prevention of anaerobic infections during operations, 100 ml of the drug is administered intravenously before surgery; on the day of surgery and the next day, 1.5 g is injected - 100 ml of the drug (500 mg) with an interval of eight hours. The period of metronidazole therapy should not be more than ten days.

In exceptional cases, this period may be extended. It is recommended not to reuse the drug. Antibiotics are administered separately from metronidazole.

For children under twelve years of age, metronidazole is injected intravenously at 5 ml / min every 8 hours at the rate of 1.5 ml / kg of body weight. It is recommended to switch to oral administration of metronidazole as soon as possible.

Metronidazole is taken as tablets by mouth during or after meals, without chewing. It is possible to drink the medicine with milk. In the treatment of trichomoniasis, the treatment is selected by the doctor individually. The one-day course of treatment is two grams (eight tablets) at a time, or in two divided doses of one gram (four tablets) twice a day.

This course of therapy is recommended in cases where there is a suspicion that the patient will not carry out the intended appointment at the specified time interval. A treatment period of seven days, 250 mg (half a tablet) is recommended 3 times a day. The effectiveness of treatment in the latter case is guaranteed to be high.

Metronidazole - use in the treatment of amebiasis for adults is recommended 750 mg (one and a half tablets) orally three times a day for five to ten days. In the case of liver abscess - 500 mg or 750 mg 3 times a day for a period of five to ten days. For children, the daily dose is 35-50 mg / kg, calculated for three oral doses for a period of ten days.

Instructions for the use of metronidazole tablets in gynecology
Instructions for the use of metronidazole tablets in gynecology

In the treatment of severe anaerobic bacterial infections, the drug is recommended at the very beginning of treatment. The oral dose for adults is 7.5 mg / kg at intervals of 6 hours. The highest dose per day is 4 g. The treatment period is from seven to ten days. In the case of the treatment of infections of the joints and bones, the lower respiratory tract and the endocardium, the period may be lengthened.

Metronidazole is used in the treatment of elderly patients. In this case, the treatment regimen may undergo some changes. It will be necessary to monitor the concentration of the drug in the blood to determine the dose. In patients with severe liver disease, the concentration of metronidazole in the blood is observed, and therefore its rate should be reduced.

It is necessary to closely monitor the concentration of metronidazole in the blood and signs of poisoning by it. In the case of a complete cessation of the flow of urine into the bladder, it is not recommended to reduce the dose of the drug because metronidazole and its components are removed during dialysis.

Metronidazole gel is recommended for topical, external use. The gel is applied to previously cleansed infected areas of the mucous membrane or skin with a small layer at intervals of 12 hours in the morning and evening hours. The effectiveness of the treatment is ascertained 20 days after the use of the drug. The course of therapy is from one to four months.

Suppositories metronidazole are injected into the vagina with a single dose of 2 g or 500 mg twice a day in the morning and evening for ten days. Sexual intercourse is not recommended during the treatment period.

Metronidazole in the fight against bacterial vaginosis

Bacterial vaginosis is a very common disease, which is often referred to in medicine as polyetiological nonspecific vaginitis. This disease occurs as a result of exposure to a woman's body of a bacteria called Gardnerella vaginalis.

In some cases, other anaerobic microorganisms also become the cause of the development of this ailment. Bacterial vaginosis is a disease characterized by a marked decrease in the number of lactobacilli. As a result, there are serious changes in the vaginal microflora.

Metronidazole is used for the treatment of bacterial vaginosis in the form of a preparation in the form of suppositories and gel. Metronidazole gel must be used before going to bed. The course of treatment is five days, but suppositories must also be injected at night for five to seven days.

Very often, this disease is also accompanied by such an ailment as candidal colpitis. To treat this condition, medical specialists most often prescribe a drug called metronidazole. This pharmaceutical is available in several pharmaceutical forms.

As a rule, in the fight against this ailment, metronidazole is prescribed to the patient along with many other drugs. This is explained by the fact that the treatment of bacterial vaginosis should be comprehensive. Some special dietary supplements (biologically active additives) are considered to be all effective means for combating various gynecological diseases of an infectious nature.

Metronidazole - use in gynecology

Instructions for the use of metronidazole tablets in gynecology
Instructions for the use of metronidazole tablets in gynecology

This remedy is a very popular antimicrobial and antibacterial medicine. It is used to treat skin diseases, correct respiratory tract infections, and so on. The drug "Metronidazole" is widely used in gynecology.

It is worth noting that the agent is able to perfectly fight against many pathogenic microorganisms. However, its use will be completely useless in the treatment of fungal infections and diseases of viral origin. That is why it is worth first finding out what is the causative agent of the pathology.

Metronidazole is used in gynecological practice when it is used as an antibacterial remedy in the fight against infections in women. The specialist prescribes the drug, according to the indications for use, for the treatment of: endometritis; infections of the vaginal vault; abscess of the fallopian tubes; ovarian infections; trichomoniasis; Trichomonas vaginitis; bacterial vaginitis; urethritis; ovarian abscess.

It is often advisable to use Metronidazole for the prevention of inflammatory processes in the postoperative period. The effectiveness of the drug in therapeutic measures for the treatment of septic diseases in obstetrics and gynecology has been proven on many years of medical experience.

It should be noted that in each case, a separate dosage and treatment regimen is selected. You can never independently deviate from the received appointments. Otherwise, you may not only fail to get a positive result, but also cause complications.

Features of use during pregnancy and lactation

Instructions for the use of metronidazole tablets in gynecology
Instructions for the use of metronidazole tablets in gynecology

According to the instructions attached to the medicine, Metronidazole belongs to category B, which means restrictions on use during pregnancy and lactation.

Metronidazole quickly crosses the placental barrier. The use of this medication is prohibited in early pregnancy. If vital indications require drug therapy, then the pregnancy is terminated.

During the periods of the 2nd and 3rd trimesters of pregnancy, the advisability of using Metronidazole should be due to vital indications.

Since the active substance of the drug is excreted in breast milk, there is a need for a temporary cessation of lactation.

Recommendations for the use of metronidazole

The use of metronidazole together with amoxisar is not recommended for children under eighteen years of age. In the case of a protracted period of treatment, it is recommended to regularly take a blood test. If there is a decrease in the number of leukocytes, further continuation of therapy depends on the possibility of infection.

If there is a disorder of coordination of movements, confusion or other regression of the patient's motor activity, it is necessary to suspend metronidazole therapy. Immobility of pale treponemas is possible and, as a consequence, a false positive modern trepomeric TPI test.

There is a dark staining of urine. During pregnancy, starting from 3 months of conception, metronidazole can be used in exceptional cases associated with a threat to life.

Due to the influence of metronidazole on concentration, its decrease and leading to confusion, special care should be taken by drivers and workers with dangerous machinery.

During the period of metronidazole therapy, it is forbidden to use ethyl alcohol (there is the appearance of extremely negative sensations as a result of acute intoxication, accompanied by a real fear of death: noise in the head, hot flashes, vomiting, shortness of breath, decreased blood pressure, abdominal pain).

The effect of metronidazole on the recognition of the following lipid profile values ​​has been scientifically proven, such as the AST enzyme, ALT enzyme, an enzyme that takes part in glycolysis reactions, fats, and a cytoplasmic enzyme.

Instructions for the use of metronidazole tablets in gynecology
Instructions for the use of metronidazole tablets in gynecology

When treating trichomoniasis, sexual partners should refuse to have sex for the period of treatment. At the end of treatment, it is required to confirm the onset of the effect by laboratory means three times with an interval before and at the end of the menstrual cycle.

The use of the drug during the first three months of pregnancy is prohibited. In the remaining six months, metronidazole therapy is possible, taking into account the determination of the degree of benefit to the fetus. The drug, penetrating the placenta, easily enters the bloodstream of the embryo, and therefore carries the risk of deformities and mutations. The ultimate risk in pregnant women has not been scientifically proven.

Since metronidazole provokes the possibility of malignant neoplasms in the order of rodents, this drug should be taken in the most extreme and severe cases of disease.

In case of forced use of metronidazole during breastfeeding, breastfeeding should be suspended. The drug passes into breast milk in the same amounts as in the blood.

The use of a drug for the treatment of trichomoniasis during pregnancy may be an exception when other therapy is unsuccessful.

Instructions for the use of metronidazole tablets in gynecology
Instructions for the use of metronidazole tablets in gynecology

When using metronidazole in the form of a gel, cover the entire infected skin area with it. Since the preparation for external use excludes the content of fat in its composition, it is not visible on the skin of the face and does not leave stains on clothes. It is possible to use cosmetics after applying metronidazole.

When treating trichomoniasis, it is also recommended to jointly use metronidazole in the form of tablets. In such cases, it should be, especially if the therapy is repeated, a laboratory test of the blood should be performed to prevent a decrease in leukocytes below normal.

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